Fruit and vegetables, and cardiovascular disease: a review.

Ness, Andy R; Powles, John

doi:10.1093/ije/26.1.1

Cited by 1,122 publications

(628 citation statements)

References 39 publications

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“…Alternatively, plasma levels of beta-carotene and alphatocopherol may be seen as markers of consumption of other nutrients with similar food sources, such as other antioxidants (Rice-Evans & Miller, 1995) (¯avonoids (Hertog et al, 1993), ferulic acid (Graf, 1996), glutathione (Jones et al, 1992)), folate (Boushey et al, 1995) or non-starchy ®bres (Rimm et al, 1996). A bene®cial effect of high dietary consumption of fresh fruits and vegetables, the main source of antioxidants, was repeatedly shown in epidemiological studies (Rimm et al, 1996;Key et al, 1996;Ness & Powles, 1997). This explanation would also accommodate the results of the recent clinical trials which failed to show any bene®cial effects of beta-carotene supplementation on the occurrence of CVD (The Alpha-Tocopherol, BetaCarotene Cancer Prevention Study Group, 1994;Hennekens et al, 1996;Omenn et al, 1996).…”

Section: Discussionmentioning

confidence: 96%

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Bobák

Brunner

et al. 1998

Eur J Clin Nutr

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Objectives: To compare plasma levels of antioxidant vitamins in the Czech population with those in a western European population, and to investigate whether plasma levels of antioxidant vitamins in Czech population are related to risk of MI. Design: The study has two parts: a cross-sectional survey and a population based case-control study. Setting: Adult population in two districts of the Czech Republic, and London based civil servants group as the comparison. Subjects: A random sample of men and women aged 25±64 y resident in two districts were selected for the cross-sectional survey. Subjects in the age group 40±49 y were compared to a sample of British civil servants of the same age enrolled in the Whitehall II Study. Men in the Czech sample served as controls to 52 male cases of ®rst non-fatal myocardial infarction (MI) which occurred in the same population. Plasma samples were obtained from venepuncture during an interview in hospital in the population sample and immediately after hospitalization in the MI cases. Main outcome measures: Plasma levels of b-carotene and a-tocopherol, and the event of MI. Identical protocol and one laboratory was used for all analyses. Results: The mean plasma levels of b-carotene and a-tocopherol in healthy Czech men and women were substantially lower than in a subsample of British civil servants examined in the same laboratory. Smoking was strongly related to b-carotene in both populations but differences between Czechs and Brits were present in both smokers and non-smokers. In the case-control study among Czech men, low levels of the vitamins were strongly related to an increases risk of MI. Age-adjusted odds ratios for concentrations below the median were 3.33 (95% con®dence interval 1.43±8.33) for b-carotene and 1.89 (0.94±3.45) for a-tocopherol; further adjustment for a range of variables reduced these estimates only slightly. Conclusions: Plasma concentrations of antioxidants in the Czech population appeared to be very low, and men with low levels of these substances are at increased risk of MI. This indicates that sub-optimal intake of antioxidants or related dietary factors may have played a role in the high rates of coronary heart disease in this population. Sponsorship: This study was supported by grants from the Wellcome Trust, Czech Ministry of Health and the British Heart Foundation. MB was a Wellcome Trust fellow in clinical epidemiology.

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Section: Discussionmentioning

confidence: 96%

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Bobák

Brunner

et al. 1998

Eur J Clin Nutr

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“…This has led to some researchers questioning the efficacy of antioxidants per se in reducing chronic disease risk and suggesting that antioxidants could merely be acting as a marker of the body status of 'other' entities, which might ultimately be responsible for the associations observed in epidemiological studies. At the same time, increased intakes of foods, also rich in antioxidants such as fruits and vegetables (Ness and Powles, 1997;Law and Morris, 1998;Genkinger et al, 2004;La Vecchia, 2004), and whole grain cereals (Slavin, 2003;Seal, 2006) have been associated with a decrease in the risk of chronic diseases including cancer and cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Influence of habitual diet on antioxidant status: a study in a population of vegetarians and omnivores

et al. 2007

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Background: Antioxidant status can be used as a biomarker to assess chronic disease risk and diet can modulate antioxidant defence. Objective: To examine effects of vegetarian diet and variations in the habitual intakes of foods and nutrients on blood antioxidants. Subjects and Setting: Thirty-one vegetarians (including six vegans) and 58 omnivores, non-smokers, in Northern Ireland. Design: A diet history method was used to assess habitual diet. Antioxidant vitamins, carotenoids, uric acid, zinc-and ferricreducing ability of plasma (FRAP) were measured in fasting plasma and activities of glutathione peroxidase (GPX), superoxide dismutase (SOD) and glutathione S-transferase (GST) and level of reduced glutathione (GSH) were measured in erythrocytes. Results: Vegetarians had approximately 15% higher levels of plasma carotenoids compared with omnivores, including lutein (Pp0.05), a-cryptoxanthin Pp0.05), lycopene (NS), a-carotene (NS) and b-carotene (NS). The levels/activities of all other antioxidants measured were similar between vegetarians and omnivores. Total intake of fruits, vegetables and fruit juices was positively associated with plasma levels of several carotenoids and vitamin C. Intake of vegetables was positively associated with plasma lutein, a-cryptoxanthin, a-carotene and b-carotene, whereas intake of fruits was positively associated with plasma b-cryptoxanthin. Intake of tea and wine was positively associated with FRAP value, whereas intake of herbal tea associated positively with plasma vitamin C. Intakes of meat and fish were positively associated with plasma uric acid and FRAP value. Conclusions: The overall antioxidant status was similar between vegetarians and omnivores. Good correlations were found between intakes of carotenoids and their respective status in blood.

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“…There is a large body of evidence to suggest that high dietary intakes of fruit and vegetables are associated with reduced risk of cardiovascular disease, stroke and cancer (Ness & Powles, 1997). Fruits and vegetables are rich sources of antioxidants, which are thought to inhibit oxidation of lowdensity lipoprotein (LDL) cholesterol, a process that is considered to be a prerequisite for atherosclerosis (Witztum & Steinberg, 1991).…”

Section: Introductionmentioning

confidence: 99%

The relation between dietary flavonol intake and coronary heart disease mortality: a meta-analysis of prospective cohort studies

2003

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Objective: To assess the association of dietary flavonol intake with the subsequent risk of coronary heart disease (CHD) mortality. Design: Meta-analysis of prospective cohort studies published before September 2001. Studies were identified by MEDLINE and EMBASE searches and by scanning relevant reference lists. The following information was extracted from published reports: size of cohort, mean age, mean duration of follow-up, number of fatal CHD events, mean flavonol intake, main sources of flavonol intake, degree of adjustment for potential confounders, and the relation of CHD mortality to dietary flavonol intake measured at baseline. Results: Seven prospective cohorts of men and women were identified including a total of 2087 fatal CHD events. Comparison of individuals in the top third with those in the bottom third of dietary flavonol intake yielded a combined risk ratio of 0.80 (95% CI 0.69-0.93) after adjustment for known CHD risk factors and other dietary components. Conclusion: This overview of prospective cohort studies indicates that high dietary intake of flavonols from a small number of fruits and vegetables, tea and red wine may be associated with a reduced risk from CHD mortality in free-living populations.

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Fruit and vegetables, and cardiovascular disease: a review.

Cited by 1,122 publications

References 39 publications

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Influence of habitual diet on antioxidant status: a study in a population of vegetarians and omnivores

The relation between dietary flavonol intake and coronary heart disease mortality: a meta-analysis of prospective cohort studies

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